Integrated method and system for diagnosis determination

ABSTRACT

A method and system for creating a database for diagnosis determination that includes receiving baseline symptoms in a memory, receiving diagnoses in the memory, classifying the diagnoses that correspond to the baseline symptoms as diagnoses linked to the baseline symptoms, and rendering the diagnoses accessible on the basis of the corresponding baseline symptoms. A method and system for determining a diagnosis and treatment that includes receiving patient symptoms, comparing patient symptoms to previously stored baseline symptoms, identifying the patient symptoms that correspond to the baseline symptoms, and providing diagnoses that correspond to the identified patient symptoms to a user.

This application claims priority from U.S. provisional application No.60/774,197, filed Feb. 17, 2006, and U.S. provisional application No.60/872,478, filed Dec. 4, 2006, each of which is incorporated herein byreference in its entirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a method and system for diagnosis of apatient based on the patient's symptoms. Specifically, the presentinvention relates to a method and system for the automated determinationof the appropriate diagnosis of a patient on the basis of the patient'ssymptoms.

2. Background of the Related Art

As it may be difficult for elderly people, people with disabilities orpoor people to have access to a doctor in an adequate or optimal amountof time, a medical system for automatic diagnosis of patients isbecoming increasingly desirable. For example, Akasaka et al. (U.S. Pat.No. 5,785,650), which is incorporated herein by reference in itsentirety, teaches an integrated medical system that allows thetransmission of patient data via a network to a remote medicalpractitioner.

A patient can utilize such a prior art system while being at home. Sucha prior art system allows data, such as blood pressure andelectrocardiogram output, to be automatically transmitted. Such a systemalso allows the patient to input personal data, such as body weight, viaa keyboard at a communication terminal or to provide his/her answers toquestions posed to the patient by the system.

On the other hand, Walker et al. (U.S. Pat. No. 6,302,844), which isincorporated herein by reference in its entirety, teaches a method andapparatus for analyzing data from remote monitoring equipment anddetermining whether an anomalous event has occurred, and whether theanomalous event warrants contacting a physician. Morris et al. (U.S.Patent Application No. 2004/0078227), which is incorporated herein byreference in its entirety, teaches a system and method that are used forcreating a longitudinal medical record for an injured person andincludes a plurality of mobile computing devices having an interface forreceiving information from a first responder or a health carepractitioner.

However, none of the se systems provide an automated diagnosis methodand system that provides a patient with a viable diagnosis and treatmenton the basis of symptoms and other information provided by the patient.

SUMMARY OF THE INVENTION

In light of the above described problems and shortcomings, as well asothers, various exemplary embodiments according to this inventionprovide methods and systems for creating a database for diagnosisdetermination, the method including receiving one or more baselinesymptoms in a memory, receiving one or more diagnoses in the memory,classifying the diagnoses that correspond to the baseline symptoms asdiagnoses linked to the baseline symptoms, and rendering the diagnosesaccessible on the basis of the corresponding baseline symptoms.

Other exemplary embodiments according to this invention provide methodsand systems for determining a diagnosis and treatment, the methodincluding receiving patient symptoms, comparing patient symptoms topreviously stored baseline symptoms, identifying the patient symptomsthat correspond to the baseline symptoms, and providing one or morediagnoses that correspond to the identified patient symptoms.

Details of these and other advantages and novel features of theinvention may be set forth in part in the description that follows, andin part may become more apparent to those skilled in the art uponexamination of the following or upon learning by practice of theinvention.

BRIEF DESCRIPTION OF THE DRAWINGS

Various exemplary embodiments of the systems and methods may bedescribed in detail, with reference to the following figures, wherein:

FIG. 1 is an illustration of a system for diagnosis determinationaccording to an exemplary embodiment of the present invention;

FIG. 2 is an illustration of an exemplary user interface screen;

FIGS. 3(a)-(b) are illustrations of functional requirements according toan exemplary embodiment of the present invention;

FIG. 4 is an illustration of an exemplary assisted diagnosis display inaccordance with embodiments of the present invention;

FIG. 5 is an illustration of an exemplary recommended treatment producedin accordance with exemplary implementations of a method and system ofthe present invention;

FIG. 6 is a flow chart illustrating a method for creating a database fordiagnosis determination according to an exemplary embodiment of thepresent invention;

FIG. 7 is a flow chart illustrating a method for determining a diagnosisand treatment according to an exemplary embodiment of the presentinvention;

FIG. 8 is an illustration of an exemplary display screen representingprimary element tabs;

FIG. 9 is an illustration of an exemplary display screen for vitals;

FIG. 10 is an illustration of an exemplary display screen for allergies;

FIG. 11 is an illustration of an exemplary display screen formedications;

FIG. 12 is an illustration of an exemplary display screen for laboratorytests;

FIG. 13 illustrates an exemplary system diagram of various hardwarecomponents and other features, in accordance with an embodiment of thepresent invention; and

FIG. 14 illustrates an exemplary system diagram of various hardwarecomponents and other features in accordance with an embodiment of thepresent invention of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

These and other features and advantages of this invention are describedin, or are apparent from, the following detailed description of variousexemplary embodiments of the systems and methods according to thisinvention.

FIG. 1 is an illustration of a system for diagnosis determinationaccording to an exemplary embodiment of the present invention. In FIG.1, the system 100 includes a user terminal 110, operated by a user andconnected to a server 140 such as a web server. Users may have varyinglevels of access to system functions and ability to interact, such as,for example, add and change data in the system or perform operations,depending on the user's access level. For example, a user access levelmay be added to security information upon access of the system, such asuser name and password. According to various exemplary embodiments, theserver 140 may be a remote server, and the user terminal 110 isconnected to the server 140 via a network 120, such as the Internet.Also, the server 140 may be protected by a firewall 130, and may beconnected to a data repository 150, such as a database server. Inoperation, a user may enter information into the user terminal 110. Theinformation may be, for example, symptoms of an ailment or of anabnormal physical or mental condition. The information entered by theuser may then be transmitted via the network 120 to the server 140. Oncethe information is received by the server 140, the information is usedto determine a diagnosis, and possibly a treatment by matchinginformation for similar symptoms stored in the data repository 150.According to various exemplary embodiments, the data repository 150 maycontain a number of symptoms, and combinations of symptoms, and anycorresponding diaganoses and treatments. The diagnoses and treatments ofthat correspond to the number of symptoms are determined on the basis ofcurrent medical knowledge and experience.

The data repository 150 database is a collection of records orinformation which is stored in a computer in a systematic or structuredway, so that a user, via a computer program, for example, may consult itto answer queries. The computer program used to manage and query adatabase may be or include a database management system. The recordsretrieved in response to queries become information that can be used tomake diagnosis and treatment decisions. The database may be queried viaa series of computer screens prompting the user, whether a patient orhealth care practitioner, to enter the symptoms suffered by the patient.According to various exemplary embodiments, the various computer screensvary from providing very broad queries to more specific ones on thebasis of the responses entered for the broad queries.

FIG. 2 is an illustration of an exemplary user interface screen. In FIG.2, the screen may include of the following sections: Quick Look, PatientProfile, Contacts & Insurance, Medication, Medical Conditions,Laboratory Data, Radiology, Mammography, Doctor Visits, Procedures,Prevention/Screening, Immunization, Private Information, Document Inbox,or Account Management. Each of these sections can be accessed and/ormodified by subscribers at will. The data that is entered in each ofthese sections may be stored in a centralized data repository. Accordingto various exemplary embodiments, each section may include detaillisting views, Add New functionality and Edit functionality. Screens maybe navigated using buttons incorporated per section. It should be notedthat the informational display views may be segregated by topic to allowfor quick browsing and easy to understand viewing.

For example, once a user accesses the product via successful login, theuser may have the ability to navigate through electronic medical recordsusing the navigation options listed to the left of the content window inFIG. 2. Data additions or edits may be performed using a combination ofdata entry text boxes and a series of point-and-click drop-down boxesprepopulated with data. Users may have the ability to enter personal,emergency and physician contact information, along with basicidentifying information, such as name, address, telephone number, andthe like, using the data entry text boxes. Medical related informationthat requires users to enter procedure or test names, medication titlesor medical conditions may be selected from the prepopulated drop downlists. The system website may be developed to provide users withstandard access via a network, such as the Internet. This standardaccess encompasses standard security features, such as use of a usernameand password combination. When a valid username and password combinationare submitted to the application and validated, the user may have accessto the medical record system at a level associated with that user.

For example, the Quick Look section may provide a user with a high leveloverview of pertinent data, such as the listing screens for the patientinformation, a medical calendar, a list of allergies and/or drugreactions, an immunization reminder area, a medication listing, acurrent medical condition list and medical history. Print capabilitiesmay be available at the top of the screen to allow users to gain accessto a hard copy of this section. The Patient Profile section may providethe user with a view of patient contact information and medicalinformation that is constant and unlikely to change, such as knownallergies and medical background information. The background informationmay track data that can relate to health habits, such as occupation,alcohol and drug intake, caffeine intake, and the like. Users can alsoprovide a relevant overview of basic health information such as bloodtype, date of birth, Human Immunodeficiency Virus (HIV) status anddomestic violence exposure. The Contacts & Insurance section may allowthe user the ability to enter emergency, physician and insurance contactand coverage information, including addresses, telephone numbers andemail addresses. The Insurance portion of this section may provide theuser with a central location for storing all active insuranceinformation. This area may allow users to enter/update primary insuranceprovider. The Medication section may provide the user with acomprehensive listing of medications, including, for example, name,start date or end date and dosage information. The default view of thissection may include a 12-month drug usage graph that provides the userwith a graphical view of the patient's medication intake.

The Medical Conditions section may provide the user with an area toenter, update and track medical conditions. The default view of thissection may provide a complete list of all entered conditions, and usershave the option to enter more detail, post notes to each condition oradd new conditions as needed. The Laboratory Data section may include atracking program for laboratory and related medical testing information.It may include blood pressure, pulse, blood type, complete blood count(CBC), and cholesterol, for example laboratory results can be uploadedto a health manager to manage medical record for future reviews byphysicians. The Radiology section may allow users to track radiology,medical, and surgical data. A user can enter the procedure type,additional notes and upload images to a patient's medical folder. TheMammography Information section may include a Mammography History,including the year of the mammogram, results, classification andlocation of the actual report. Users can upload actual mammogram reportsto this section if desired. The Doctor Visits section may allow users torecord doctor visits, including date of visit, reason for visit and theoutcome for each visit. The Procedures section may allow procedures tobe coordinated and consolidated chronologically. This section mayprovide users with additional backup information to assist in having amore complete personal medical record. This section may track suchprocedures as electrocardiograms, pap smears, glaucoma, podiatry, andcertain dental information. The Prevention/Screening section may allowusers to log all of the preventative measures and/or screening teststhat have been completed. Users can enter the dates of the tests, aswell as the test outcome.

The Immunization section may allow users to enter and track immunizationinformation. The default view of this section may list all enteredimmunizations; the user has the ability to add/update records. ThePrivate Information section may provide the user with an area to enteradditional information that may be categorized as private. Thisinformation can include daily journal type entries related to diet andexercise. This section may be used to track daily insulin intake and/orsugar levels for diabetics, for example. The Document Inbox section mayprovide the user with an area to manage faxed documents within apatient's account. Users have the ability to select individualelectronic documents and associate them to specific areas within thepatient's medical record. The Account Management section may provide theuser with a section to manage account information, including featuresfor setting up multiple family members per account. This section mayallow users to set up additional individuals who may need to gain accessto the medical record account; this can include any individual the usergrants access to, including personal physicians, emergency contacts, andthe like. Security measures can be selected per individual, as users canselect which sections the individual can have access to and whether ornot edit capabilities are allowed for the individual.

FIGS. 3(a)-(b) are illustrations of functional requirement screensaccording to an exemplary embodiment of the present invention. Thepatient medical record may be entered through a series of point andclick graphical user interfaces (GUI). The GUI for each primary elementis described further below. A Select Patient chart may first bedisplayed. The names of existing patients and any identification numbersassigned to each patient may be displayed. A user may scroll through thelist or search for a patient by last name or identification number. Apatient may also be added on the screen that may display informationvia, for example, a pop-up window with the fields and allow the user toenter data, such as name, identification number (ID), sex, and date ofbirth. Existing patient data may be similarly edited. Multiple patientcharts may be open at any time. For example, a health provider may enterthe reason for a patient's visit to open the patient chart. The providermay select from a displayed list, enter the reason for the visit, orsimply follow-up on the patient's visit by entering free text. A focusedassessment feature may also help guide the user, such as the provider,through the set of signs and symptoms that should be evaluated for agiven reason for the patient's visit. This guidance may be provided byhighlighting appropriate items in the assessment pages. For example,items related to a reason for the patient's visit for a cough may behighlighted in History, Physical Exam, and Medications sections of theinterface.

According to various exemplary embodiments, Primary Element buttons maydisplay secondary elements, such as History, Vitals, History of PresentIllness, and the like, in another window. Data charted within theselected element during the current visit may also be displayed. Currentdata and previously charted data may also be displayed for History,Allergies, Diagnoses, Diagnostics, Treatment, Education, Follow-Up, andOutcomes. Other information, such as history of patient visits,including the date and time of each visit and the associated Reason forthe patient's visit or Follow Up, may further be displayed. Furthermore,historical state information may be displayed, along with the usernameof the user who entered the state information, along with the dates thisinformation was charted, as shown in the Item History. Thus, the healthprovider is able to chart medical history by selecting one of aplurality of check boxes, as discussed above. Notes may also be added toany chart.

A search option may also be available to allow a user to navigate thechart hierarchy. Results of the search may be displayed in a searchresults window, which includes the hierarchy path to the search entry.Furthermore, recorded allergies, such as the patient's reaction and thedate the allergy was recorded, may also be displayed at the user'srequest. New allergies and the patient's reaction are recorded from apredefined selection list, or the user, such as a health provider, mayenter a new allergy and reaction as free text. New medications may berecorded from a predefined selection list, or the provider may enter anew medication as free text. Laboratory results may also be entered byselecting from a predefined selection list. Selection from thepredefined category list may display a predefined list of laboratoryorders. Selection of a laboratory order displays a predefined test name.Selection of a test name may display the normal limits for the giventest and may allow the user to enter the laboratory result. Finally, theuser may enter diagnostic test results by selecting from a predefinedcheck list. Selection from the list may display a predefined check listof defined tests. Selection of a result may add the diagnostic test andresult to the patient chart.

FIG. 4 is an illustration of an exemplary assisted diagnosis displayscreen. In FIG. 4, an exemplary list of potential diagnoses generated bythe method or system of the present invention as recommendations to thehealth provider are displayed, as well as a list of the clinicaldecisions made by the provider. The differential diagnosis list may bebased on patient data processed through decision support modules. Eachrecommendation may include a likelihood generated by the system, whichprovides a level of confidence associated with the recommendation. Thereare four possible likelihoods displayed in decreasing order ofconfidence in the exemplary application shown in FIG. 4. The differentlikelihoods include: 1)“Consider,” which means that the signs andsymptoms are consistent with the diagnosis; 2) “Rule Out,” which meansthat the signs and symptoms are consistent with the diagnosis andsufficiently relevant that the system recommends further investigationor diagnostic testing associated with the diagnosis; 3) “Probable,”which means that the signs and symptoms and/or diagnostic results arehighly relevant to the diagnosis; and 4) “Confirm,” which means that thesigns and symptoms and/or diagnostic results are highly relevant to thediagnosis, and laboratory results are sufficient to provide highconfidence. System Recommendations may or may not be recorded in thepatient medical record. A diagnosis may only be recorded when theprovider makes a Clinical Diagnosis by setting the final status of arecommendation.

The provider or other authorized user may move any of the SystemRecommendations to the top of the screen, where they become ClinicalDecisions by first selecting the recommendation from the list and thenselecting the ‘Status’ button, for example. The provider may then setthe Status as ‘Confirmed,’ ‘Probable,’ ‘Potential,’ or ‘Ruled Out.’ Thesystem may insert the date of the decision (e.g., automatically), whichmay be edited by the provider to record a previously determined clinicaldecision. When editing the date of the decision or entering any otherdata in the patient record, the system may record (e.g., automatically)the time and date of the entry in the database. The provider may alsochange the status of an existing Clinical Decision by first selectingthe decision and then selecting ‘Status.’ Clinical Decisions may bedisplayed chronologically, with the most recent decision at the top ofthe list.

The provider or other authorized user may also set a clinical decisionfor a diagnosis that does not appear in the system generateddifferential diagnosis list by adding a diagnosis from the full list ofdiagnoses included in the system. These diagnoses may appear, forexample, in a drop down menu. The provider may then select theappropriate diagnosis and set the Status as described above. If thediagnosis is not included in the drop down menu, the provider may alsotype the diagnosis in a blank field provided in the menu. An icon orbutton may also be provided to display a pop-up check list that includesall elements of an embedded protocol for that specific diagnosis. Theicon may be linked to elements that have been charted for the specificpatient, thus providing a rationale for the recommendation. The providermay remove any checked element from the patient chart by selecting achecked box, or chart additional patient data by selecting elements thatare not checked. Either action, once saved, may cause patient data to bereprocessed through all protocols that contain the checked or uncheckedelements.

According to various exemplary embodiments of the present invention, ahistory of all Clinical Diagnoses that have been entered for the currentpatient may also be displayed, but only the most recent status and dateof each diagnosis. The full history of a particular diagnosis may bepresented in a pop-up display by selecting the diagnosis. Furthermore,the health provider may attach notes to a Clinical Decision, and apop-up edit screen may be displayed that includes any notes previouslyattached to the decision and allows the provider to add new oradditional notes.

FIG. 5 is an illustration of an exemplary recommended treatment screenin accordance with an embodiment of the present invention. According tovarious exemplary embodiments, the listing of the diagnostics found maybe based upon the likelihood of the diagnosis, such as, as discussedabove, Consider, Rule Out, Probable, or Confirm. For example, if arecommended treatment is selected by a user by, for example, clicking onan icon, the full path to the recommended treatment may be highlightedto allow the user to focus on that treatment. An example is shown inFIG. 5, where Morphine Sulfate has been highlighted as the result of atreatment recommendation. As a navigational aide to the user, note thatsmall arrows may also appear at the top and bottom of the Medicationslist. These arrows indicate that additional items have been highlightedby the refocused assessment process. Selecting either of these arrowscauses the Medications window to scroll to the next highlightedmedication. The listing of the diagnostics found will be based upon thelikelihood of the diagnosis: Consider, Rule Out, Probable, or Confirm.

Furthermore, data mining reports may be generated to provide summaryreports, such as Medical Encounter Summary, Diagnoses Report, SymptomReport, and Intervention Report. According to various exemplaryembodiments, the Medical Encounter Summary report allows the user toselect a start date and an end date of the report. The report may alsodisplay summary statistical data, as shown at the bottom of the figure.The Diagnosis Report allows the user to select a particular problem and(e.g., status from drop down menus), and to display summary statisticaldata. The Symptom Report allows the user to select several levels ofsymptoms from, for example, drop down menus, and may display summarystatistical data. The Intervention Report allows the user to select thetype of intervention (Diagnostics, Treatment, Education, or Follow-Up),or a particular intervention and the status of interventions (All, Done,Ordered, or Pending).

FIG. 6 is a flow chart illustrating a method for creating a database fordiagnosis determination, in accordance with an exemplary embodiment ofthe present invention. In FIG. 6, the method starts in step S100 andcontinues to step S110, where baseline symptoms are received. Forexample, baselines symptoms may be any symptoms currently known to haveoccurred on people or animals, and that are symptomatic of an abnormalphysical or mental condition. Baseline symptoms may be a headache, chestpain, bleeding, loss of consciousness, temporary loss of vision, and thelike. When received, the baseline symptoms may be stored in memory.Next, the method continues to step S120, where the various diagnosescorresponding to the received symptoms are also received and stored inmemory. For example, a diagnosis of “stroke” may be entered ascorresponding to the baseline symptom “loss of consciousness.” Also, aplurality of diagnoses may be received that correspond to the samebaseline symptom. For example, not only a diagnosis of “stroke” may bereceived as corresponding to the baseline symptom “loss ofconsciousness,” but also a diagnosis of “heat exhaustion” or “emotionaltrauma” can be received that corresponds to the same baseline symptom of“loss of consciousness.” Furthermore, other diagnoses may be receivedthat correspond to not only one baseline symptom, but to a combinationof baseline symptoms. For example, the diagnosis “stroke” may bereceived as corresponding to the combination of “loss of consciousness”and “loss of the ability to speak.” Accordingly, the combination of thetwo baseline symptoms “loss of consciousness” and “loss of the abilityto speak” effectively results (i.e., through a decision tree function inthe software) in the elimination of the diagnoses “heat exhaustion” and“emotional trauma” because the combination of the two baseline symptomsis more likely to correspond to the diagnosis “stroke” than to any oneof the other two possible diagnoses. Thus, another class of diagnosescan be received that corresponds to a combination of baseline symptoms,such that a smaller number of possible diagnoses is received becausethese diagnoses correspond to a combination of baseline symptoms.

Ultimately, if a large enough number of baseline symptoms are combined,only one corresponding diagnosis may be associated with this combinationand stored in memory. Furthermore, the diagnoses may be regularlyupdated on the basis of the latest medical progress. Next, the methodcontinues to step S130, where the various received diagnoses areclassified in terms of the baseline symptoms to which they correspond,and in terms of any combinations of baseline symptoms to which theycorrespond. For example, the diagnosis “stroke” can be classified asbeing a possible diagnosis for each baseline symptom “loss ofconsciousness,” “garbled language,” and “loss of vision,” and also forbeing a possible diagnosis for any combinations of these three baselinesymptoms. Next, the method continues to step S140, where the diagnosesare rendered accessible on the basis of the baseline symptoms. In otherwords, an interface may be made available to a user to allow the user toassociate the different diagnoses and their corresponding symptoms orcombinations of symptoms for access for diagnosis and treatment purposesbased on symptoms and other information. Next, the method continues tostep S150, where the method ends.

It should be noted that various symptoms may be assigned differentweight in the determination of a final diagnosis. For example, thesymptom of “loss of the ability to speak” may be assigned a greaterweight than the symptom of “loss of consciousness” in the determinationof the diagnosis of a “stroke.” Furthermore, other symptoms may beassigned a different weight because, for example, they may eliminate agiven diagnosis. For example, the symptom “belly ache” may be weightednegatively in relation to the diagnosis “stroke.” In other words, if thesymptom “belly ache” is received, then the diagnosis “stroke” may beeliminated from the list of possible diagnoses.

FIG. 7 is a flow chart illustrating a method for determining a diagnosisand treatment according to an exemplary embodiment of the presentinvention. In FIG. 7, the method starts in step S200 and continues tostep S210, where patient symptoms are received. For example, patientsymptoms may be any symptoms currently known to have occurred on apatient, and that are symptomatic of an abnormal physical or mentalcondition of the patient. Patient symptoms may be a headache, chestpain, bleeding, loss of consciousness, temporary loss of vision, and thelike. Next, the method continues to step S220, where the receivedpatient symptoms are compared to the stored baseline symptoms. Accordingto an exemplary embodiment, the patient symptoms are compared to everysingle baseline symptom stored in memory, and in the case of acombination of patient symptoms, that combination is compared to everycombination of baseline symptoms stored in memory. Next, controlcontinues to step S230, where all the baseline symptoms that correspondto the patient symptoms are identified. According to an exemplaryembodiment, in the case where a combination of patient symptoms isreceived, then either all or a part of the patient symptoms of thatcombination are identified to one or more combinations of baselinesymptoms on the basis of a similarity between patient symptoms andbaseline symptoms. Next, the method continues to step S240, where thediagnoses that correspond to any identified baseline symptom, or to anyidentified combination of baseline symptoms, as corresponding to thepatient symptoms, are provided to a user. For example, the diagnoses maybe displayed on a computer screen, or printed out on an imaging medium.Next, the method continues to step S250, where the method ends.

FIG. 8 is an illustration of an exemplary display screen representingprimary element tabs. In FIG. 8, the primary element tabs below thescreen header represent the highest level of the hierarchical structurefor the protocol files. The tabs may consist of Medical History, Vitals,History of Present Illness (HPI), Physical Exam (PE), Allergies,Medications (Meds), Laboratory (Labs) tests, Diagnosis (Dx) Tests andTreatment. A user may, by clicking on each of these tabs, access adifferent display screen for entering the protocol information.

FIG. 9 is an illustration of an exemplary display screen representing anexemplary display screen for vitals. In FIG. 9, the vitals are added toa protocol file by entering a mathematical operator such as “<,” “<=,”“>=,” or “>,” and a value for the particular vital. For example, on FIG.9, the Blood Pressure SBP of a patient is greater than 145.

FIG. 10 is an illustration of an exemplary display screen representingan exemplary display screen for allergies. In FIG. 10, to add an allergyto the allergy list, a user may set the focus to the “Allergy” list andenter the allergy in the “Element Name” text box and then click “Add.”To delete an allergy from the allergy list, a user may select theallergy from the “Allergy” list and click the “Delete” button.

FIG. 11 is an illustration of an exemplary display screen formedications. In FIG. 11, to add a medication to the medication list, auser may enter the name of the medication in the “Element Name” text boxand click the “Add” button. Similarly, to delete a medication from thelist, the user may select the medication in the medication list andclick the “Delete” button.

FIG. 12 is an illustration of an exemplary display screen for laboratorytests. In FIG. 12, the procedure for adding and deleting elements issimilar to the procedure described above. When selecting elements to addto the protocol file, a user may see the result of the laboratory teststo be positive or negative in the “Value” edit box. The user may alsoset an operator in the “Operator” box and set a numeric value in the“Value” edit box.

The present invention may be implemented using hardware, software or acombination thereof and may be implemented in one or more computersystems or other processing systems. In one exemplary embodiment, thepresent invention may be implemented using a Dream Weaver interface andVisual Basic programming. The present invention may also be implementedvia three major elements: a Personal Medical Record element, anAuthorware element, and a Clinical encounter tool element. These threeelements may be functionally coupled in order to achieve a properdiagnosis determination on the basis of a patient's symptoms. Accordingto various exemplary embodiments, a fourth element, a Command andControl Interface, may be added.

The Personal Medical Record element may be the portion where a patientmay use the application to manage information pertaining to his/herclinical or medical history. Thus, the patient may create a PersonalMedical Record (PMR). This is the application that, for example,contains Quick Look, Vaccination history and other elements describedabove. Data from this application may be stored in a secured way that isreadily accessible to the patient or to a health care operator. Thedegree to which the application can be accessed by the health careoperator may also be set, for example, by the patient.

The Authorware element may be an element that a subject matter expert,without computer programming skills, may use to generate a knowledgebase consisting of XML code that may be integrated into a ClinicalEncounter Tool in order to provide real time decision support. The userinterface for this application may be identical to the user interfacefor the Clinical Encounter Tool. The subject matter expert may use thistool to, for example, identify the symptoms that are relevant to aparticular diagnosis, weigh symptoms relative to a given diagnosis,detail the rationale for particular decisions, and provide detailedtreatment recommendations with regard to each individual diagnosis. Theoutput of this application may be an XML knowledge base that may beintegrated, in a plug and play fashion, with the Clinical EncounterTool.

The Clinical Encounter Tool may integrate data from the Personal MedicalRecord and input from the clinician during the clinical encounter withthe decision support knowledge base generated by the subject matterexperts using the Authorware. In other words, the Clinical EncounterTool functionally couples the data from both the Personal Medical Recordand the Authorware to achieve the result of providing treatmentrecommendations, and may be implemented by a health care operator suchas, for example, a clinician. The result is real time recommendationsregarding diagnosis and treatment as well as readily availableexplanations regarding the rationale for such recommendations. Asdiscussed above, the user interface for this application may be similarto the user interface for the Authorware application. Additionalfeatures may include a plug-and-play integration of knowledge bases, theintegration of data from the PMR and the ability of individual ClinicalEncounter Tools to synchronize their information with a network-basedcommand and control interface, such as a web-based command and controlinterface. Additionally, another party such as, for example, a manager,may oversee the operation of the entire system that includes theabove-described elements and, for example, obtain situational awareness,direct resources to specific areas or take action based on real-timedata. Such a system may also be used in the context, for example, of anetwork of health care providers.

Additional features may include a plug-and-play integration of knowledgebases, the integration of data from the PMR and the ability ofindividual clinical encounter tools to synchronize their informationwith a network-based command and control interface, such as a web-basedcommand and control interface. For example, a Command and ControlInterface may allow for the networking and oversight, in real time, of alarge number of personnel that may be actively acquiring clinicalinformation and managing patients. In the context of a complex emergencyfor example, it provides for situational awareness and improved dataintegration and analysis. Overall features of the system may includesecure, two way communication, data integration and point of caredecision support.

In one exemplary embodiment, the invention is directed toward one ormore computer systems capable of carrying out the functionalitydescribed herein. An example of such a computer system 900 is shown inFIG. 13.

Computer system 900 includes one or more processors, such as processor904. The processor 904 is connected to a communication infrastructure906 (e.g., a communications bus, cross-over bar, or network). Varioussoftware embodiments are described in terms of this exemplary computersystem. After reading this description, it may become apparent to aperson skilled in the relevant art(s) how to implement the inventionusing other computer systems and/or architectures.

Computer system 900 can include a display interface 902 that forwardsgraphics, text, and other data from the communication infrastructure 906(or from a frame buffer not shown) for display on the display unit 930.Computer system 900 also includes a main memory 908, preferably randomaccess memory (“RAM”), and may also include a secondary memory 910. Thesecondary memory 910 includes, for example, a hard disk drive 912 and/ora removable storage drive 914, representing a floppy disk drive, amagnetic tape drive, an optical disk drive, etc. The removable storagedrive 914 reads from and/or writes to a removable storage unit 918 in awell-known manner. Removable storage unit 918, represents a floppy disk,magnetic tape, optical disk, etc., which is read by and written toremovable storage drive 914. As may be appreciated, the removablestorage unit 918 includes a computer usable storage medium having storedtherein computer software and/or data.

In alternative embodiments, secondary memory 910 includes other similardevices for allowing computer programs or other instructions to beloaded into computer system 900. Such devices include, for example, aremovable storage unit 922 and an interface 920. Examples of such mayinclude a program cartridge and cartridge interface (such as that foundin video game devices), a removable memory chip (such as an erasableprogrammable read only memory (“EPROM”), or programmable read onlymemory (“PROM”)) and associated socket, and other removable storageunits 922 and interfaces 920, which allow software and data to betransferred from the removable storage unit 922 to computer system 900.

Computer system 900 also includes, for example, a communicationsinterface 924. Communications interface 924 allows software and data tobe transferred between computer system 900 and external devices.Examples of communications interface 924 may include a modem, a networkinterface (such as an Ethernet card), a communications port, a PersonalComputer Memory Card International Association (“PCMCIA”) slot and card,etc. Software and data transferred via communications interface 924 arein the form of signals 928, which may be electronic, electromagnetic,optical or other signals capable of being received by communicationsinterface 924. These signals 928 are provided to communicationsinterface 924 via a communications path (e.g., channel) 926. This path926 carries signals 928 and may be implemented using wire or cable,fiber optics, a telephone line, a cellular link, a radio frequency(“RF”) link and/or other communications channels. In this document, theterms “computer program medium” and “computer usable medium” are used torefer generally to media such as a removable storage drive 914, a harddisk installed in hard disk drive 912, and signals 928. These computerprogram products provide software to the computer system 900. Theinvention is directed to such computer program products.

Computer programs (also referred to as computer control logic) arestored in main memory 908 and/or secondary memory 910. Computer programsmay also be received via communications interface 924. Such computerprograms, when executed, enable the computer system 900 to perform thefeatures of the present invention, as discussed herein. In particular,the computer programs, when executed, enable the processor 904 toperform the features of the present invention. Accordingly, suchcomputer programs represent controllers of the computer system 900.

In an embodiment where the invention is implemented using software, thesoftware may be stored in a computer program product and loaded intocomputer system 900 using removable storage drive 914, hard drive 912,or communications interface 924. The control logic (software), whenexecuted by the processor 904, causes the processor 904 to perform thefunctions of the invention as described herein. In another embodiment,the invention is implemented primarily in hardware using, for example,hardware components, such as application specific integrated circuits(“ASICs”). Implementation of the hardware state machine so as to performthe functions described herein may be apparent to persons skilled in therelevant art(s).

In yet another embodiment, the invention is implemented using acombination of both hardware and software.

FIG. 14 shows a system 1000 usable in accordance with an embodiment ofthe present invention. The system 1000 includes an accessor 1060 (alsoreferred to interchangeably herein as a “user”) at a terminal 1042. Inone exemplary embodiment, data for use in accordance with the presentinvention is, for example, input and/or accessed by the accessor 1060via the terminal 1042, such as a personal computer (PC), minicomputer,mainframe computer, microcomputer, telephonic device, or wirelessdevice, such as a personal digital assistant (“PDA”) or a hand-heldwireless device, coupled to a server 1043, such as a PC, minicomputer,mainframe computer, microcomputer, or other device having a processorand a repository for data and/or connection to a processor and/orrepository for data, via, for example, a network 1044, such as theInternet or an intranet, and couplings 1045, 1064. The couplings 1045,1064 include, for example, wired, wireless, or fiber-optic links. Inanother embodiment, the method and system of the present inventionoperate in a stand-alone environment, such as on a single terminal.

Furthermore, while this invention has been described in conjunction withthe exemplary embodiments outlined above, various alternatives,modifications, variations, improvements, and/or substantial equivalents,whether known or that are or may be presently unforeseen, may becomeapparent to those having at least ordinary skill in the art.Accordingly, the exemplary embodiments of the invention, as set forthabove, are intended to be illustrative, not limiting. Various changesmay be made without departing from the spirit and scope of theinvention. Therefore, the invention is intended to embrace all known orlater-developed alternatives, modifications, variations, improvements,and/or substantial equivalents.

1. A method for creating a database for diagnosis determination, themethod comprising: receiving one or more baseline symptoms; receivingone or more diagnoses; classifying the diagnoses that correspond to thebaseline symptoms as diagnoses linked to the baseline symptoms; andrendering the diagnoses accessible on the basis of the correspondingbaseline symptoms.
 2. The method of claim 1, wherein the receiveddiagnoses are updated in a memory on the basis of current medicalknowledge.
 3. The method of claim 1, wherein the classified diagnosescorrespond to a combination of the baseline symptoms.
 4. The method ofclaim 1, wherein the diagnoses are rendered accessible via auser-generated query.
 5. A method for determining a diagnosis andtreatment, the method comprising: receiving patient symptoms; comparingpatient symptoms to previously stored baseline symptoms; identifying thepatient symptoms that correspond to the baseline symptoms; and providingone or more diagnoses that correspond to the identified patientsymptoms.
 6. The method of claim 5, wherein the one or more diagnoseshave been previously stored in memory.
 7. The method of claim 5, whereinthe compared patient symptoms are compared to a combination of thebaseline symptoms.
 8. The method of claim 5, wherein the identifiedpatient symptoms correspond to a combination of the baseline symptoms.9. The method of claim 5, wherein the identified patient symptoms aresimilar to at least one of the baseline symptoms and a combination ofthe baseline symptoms.
 10. The method of claim 5, further comprisingproviding one or more treatment options to the patient that correspondto the provided one or more diagnoses.
 11. A system for diagnosisdetermination, the system comprising: a processor; a user interfacefunctioning via the processor; and a repository accessible by theprocessor; wherein the system: receives one or more baseline symptoms ina memory; receives one or more diagnoses corresponding to the one ormore baseline symptoms in the memory; receives patient symptoms from oneor more patients, wherein the patient symptoms are a specificcombination of symptoms; and provides one or more correspondingdiagnoses to the one or more patients; wherein the one or more diagnosesare determined on the basis of the received patient symptoms and thestored one or more diagnoses.
 12. The system of claim 11, wherein theuser interface displays a screen, wherein the screen comprises at leastone of a summary section, a patient profile section, a contacts andinsurance section, a medication, a medical conditions section, alaboratory data section, a radiology section, a mammography section, adoctor visits section, a procedures section, a prevention/screeningsection, an immunization section, a private information section, adocument inbox section, and an account management section.
 13. Thesystem of claim 12, wherein at least one of the sections are accessibleby the user.
 14. The system of claim 12, wherein the data displayed inthe sections is updated with new information.
 15. The system of claim11, wherein a unique identifier is assigned to each of the one or morepatients.
 16. The system of claim 15, wherein the patient symptoms andthe corresponding diagnosis may be accessed for each of the one or morepatients by using the unique identifier.
 17. The system of claim 11,wherein the one or more diagnoses are the result of a comparison of thespecific combination of the patient symptoms with an identicalcombination of symptoms stored in memory as the one or more baselinesymptoms.
 18. The system of claim 11, wherein an appropriate treatmentis provided on the basis of the provided one or more correspondingdiagnoses.
 19. The system of claim 11, wherein a number of the one ormore corresponding diagnoses is further reduced when more patientsymptoms are entered.
 20. The system of claim 11, wherein the one ormore diagnoses are provided by labeling the diagnoses at least one orconsider, rule out, probable and confirm.
 21. The system of claim 11,wherein the processor is housed on a terminal selected from a groupconsisting of a personal computer, a minicomputer, a main framecomputer, a microcomputer, a hand held device, and a telephonic device.22. The system of claim 11, wherein the processor is housed on a serverselected from a group consisting of a personal computer, a minicomputer,a microcomputer, and a main frame computer.
 23. The system of claim 22,wherein the server is coupled to a network via a coupling selected froma group consisting of a wired connection, a wireless connection, and afiberoptic connection.
 24. The system of claim 11, wherein therepository is housed on a server coupled to a network.
 25. The system ofclaim 11, further comprising a hand-held interface device that allowsthe user to access the repository.
 26. A computer program productcomprising a computer usable medium having control logic stored thereinfor causing a computer to integrate claim processing, the control logiccomprising computer readable program code means for: receiving one ormore baselines symptoms in a memory; receiving one or more diagnosescorresponding to the one or more baseline symptoms in the memory;receiving patient symptoms; and providing one or more correspondingdiagnoses to the patient; wherein the one or more diagnoses aredetermined on the basis of the received patient symptoms and the storedone or more diagnoses.
 27. A system for integrated of claim processing,the system comprising: means for receiving one or more baselinessymptoms in a memory; means for receiving one or more diagnosescorresponding to the one or more baseline symptoms in the memory; meansfor receiving patient symptoms; and means for providing one or morecorresponding diagnoses to the patient; wherein the one or morediagnoses are determined on the basis of the received patient symptomsand the stored one or more diagnoses.